Methods: :
33 eyes of 33 diabetic patients from 3 centers (UPMCEye Center, Jules Stein Eye Inst, and Miami VAMC) were recruitedto this open, non–randomized, pilot trial. Each patientunderwent fluorescein angiography on 2 separate occasions. Onthe first visit, the Panoramic200A was used and 1 week later,the same eye was imaged with a standard digital camera (Zeiss,Topcon TRC 501X and/or A or RC6000). For each eye, both an arteriovenousphase image and a late phase image were reviewed. An image reviewgrid, centered on the macula, was digitally placed on each imageand indexed to the specific optic nerve diameter to insure uniformity.The grid, comprised of 12 concentric rings (each 1 disc diameter(DD) apart) was subdivided into 8 equal 45 degree sectors. Thecombination of rings and sectors created as many as 96 imagegrid blocks on a single image, depending upon how far out eacheye was imaged. Results from the Panoramic 200A and conventionalcamera images using the above grid were then graded and tabulatedby a masked reviewer.

Results: :
The mean extent of the retina imaged for the Panoramic200Aand standard digital camera was 8.7±1.60 DD and 3.4±0.76DD respectively. The mean number of image sectors containingretinal ischemia was 16.9±15.04 and 3.4±4.26 inthe arteriovenous phase and 17.6±16.77 and 3.1±3.36in the late phase respectively. The mean number of sectors containingretinal neovascularization was 1.8±3.16 (arteriovenousphase) and 2.6±3.35 (late phase) for the Panoramic200A,versus 0.5±1.28 (arteriovenous phase) and 0.6±1.19(late phase) for the standard digital camera. The differencesbetween these sets of values were each statistically significant(p<0.01).

Conclusions: :
The Panoramic200A imaged a significantly largerarea of the retina and allowed more lesions to be displayedwithin the mid–peripheral and peripheral retina. The abilityof a clinician to readily detect clinically relevant lesionsin a single image with the Panoramic200A in diabetic patientsmay result in better overall care of the retinopathy in thesepatients.